Cognitive Processing Therapy Part 8 (or, how remembering horrors validates my struggles)

Image by Isvac on DeviantArt found here.

I have therapy homework to do this morning. I finally have some true alone time after almost a several days of taking care of a child having a moderate vaccine reaction and then a weekend in which I was resting to ease the fibro flare that began after doing a little yard work. My kids have been at school for 2 hours and I’ve written a long email to a friend in Pennsylvania, gone out to smoke several times and wandered through several blog posts by another WordPress user I admire and respect. And now I’m writing about the writing I’m afraid to do for therapy.

Thankfully, age has given me the wisdom to trust that these meandering paths to work are often the most effective. If I were to come home from dropping my kids off and dive directly into trauma work, I’d probably trigger anxiety or hypoarousal. I’ve had a lot of experience carefully treading the path to confronting trauma; visit the comfortable, share a little with someone safe and establish a strong sense of the Now, imbibe that which feels good and something else that provides nutrients, take a random turn and end up discovering someone else courageously doing the work I’m about to engage in, and finally write to remind myself of my capability and the infinite number of fellow travelers walking ‘alongside’ me.

I am Here Now.

I can Feel Pleasure.

I can Feed Myself Goodness.

I am Capable of Facing My Trauma.

I am in Good Company.

It still feel terrifying to willingly enter awareness of my trauma because I can never be certain what will arise and how I’ll feel during the work and directly afterwards. But as I said to my friend in the email this morning: I choose over and over and over again to be uncomfortable so that I might live with less cognitive distortion and triggering. I wouldn’t keep doing it if I weren’t sure those things will decrease. What continues to surprise me is how much distortion and capacity for triggering I must have in order to do this work year after year and still have more work to do.

And that is part of why I’m delaying, though it’s more accurate to use the term circumambulating; if I were to go directly into the trauma work I would probably be overwhelmed and I would also miss much of what I would easily have access to if I first circle around the problem with intention and awareness. The process is one of gathering strength and will because it consists of wandering about first and finding the tools needed to face what feels unfaceable and see what is true and what is false belief. And as I circle I also pick up the tools I’ll need to dismantle old beliefs and build something more realistic, secure and flexible.

Right now in Cognitive Processing Therapy I’m in part 8, which as best I can tell, is about focusing on specific identified automatic negative thoughts by looking at past traumatic events. Events are described and thoughts, beliefs and emotions are included in the descriptions. The primary automatic negative thought which reinforced the trauma is identified, challenged and then alternative beliefs and thoughts are put forth. I’ve practiced this process with recent events which triggered heightened emotional states and found it to be very effective in shifting how I perceive both myself and my environment. Now the task is to choose one traumatic situation from my past which was defined by beliefs around safety and: 1. Explore how that event reinforced beliefs around safety formed during the sexual abuse trauma that occurred during my childhood; 2. identify which patterns of problematic thinking; and 3. create a statement that will challenge the beliefs about safety with alternative thoughts and beliefs which are more realistic.

Update…It’s now Wednesday evening and I still haven’t done all of the writing. I have therapy tomorrow so I’ll be doing it last minute, which is not uncommon. It’s very hard to willingly look closely at the terrible things which happened to me during the first 22 years of my life. The more I look. the more I remember and there’s so much I don’t want to be reminded of. But when I do look I always feel validated; the C-PTSD symptoms I experience have been, and sometimes still are, debilitating and when I remember the horrors I more easily accept the physical, emotional and cognitive ways I have been affected.

Shift in focus

(Above image by KanchanMahon on deviantart.com)

I don’t talk much about being someone diagnosed with dissociative identity disorder; I even avoid thinking about it most of the time. One of the things I’m learning in Cognitive Processing Therapy is to hone the skills that help me slow down and notice thoughts, patterns of belief and what I’m feeling in my body.

I’ve recently been carefully monitoring my tendency to dissociate when I’m under stress or confronted with situations or ideas that challenge long held beliefs about myself and the traumas I’ve experienced. Last week in therapy I shared that I’ve been feeling a lot of anger towards my husband because I don’t believe he sees how hard I struggle to live with the effects of trauma, how tirelessly I work at overcoming it and how much I’ve achieved and grown. My therapist started making connections between my need to be seen and the fact that it was always the men in my life who defined my reality. My experience as a child was that I was in grave danger but my father insisted everything was fine. Abusive partners always convinced me I was the cause of the abuse they were perpetrating. Sitting there on the therapy couch I wanted to understand why being seen by a man still feels so important when it was clear that the men in my past lied to me and led to me to believe I couldn’t trust my own sense of what was real.

After she verbalized these connections she asked me how I felt. I noticed that I was sleepy, my vision blurred in and out, my mind felt confused, and it became difficult for me to find words to describe what I was experiencing. I told her I felt confused and strange. Looking back I see how the stress of confronting a terribly inaccurate belief about my inability to trust myself caused me to feel threatened.

My response to being threatened is to drift away from consciousness so I can avoid the pain of the moment. But some part of me needs to be present so I can protect myself and function. That means someone else has to step in until I can return. That someone is an alter; in this case an alter who’s expertise is damage control and grounding. She rises up to consciousness and navigates the situation I’m in and then nudges me back to into the driver’s seat. In the situation with my therapist this alter arose, processed enough of the cognitive dissonance for me to feel comfortable examining it, then coaxed me into deep breathing and orienting myself to my body sitting in my therapist’s office.

I’m only now beginning to understand the dynamics of my system of alters and how their presence impacted my survival in so many positive ways. Now that I’m paying attention, I’m able to observe it happen more often. I feel like I’m waking up to a reality that’s always been here. I’m cultivating curiosity about my alters, the triggers that elicit their presence and the ways in which they assist me when I feel unable to function. Instead of feeling shame when I get overwhelmed and need to disappear, I’m watching closely to see what leads up to those moments and what the alters do to get me through; I’m trying not to push them away anymore because when I keep them from surfacing I end up dissociating without having any backup and then I truly am helpless.

It’s suddenly clear that the reason I’m still experiencing symptoms of PTSD is because I still feel uncertain about reality and whether I can trust myself to know my own experience. When I don’t trust my experience of what’s happening around me, I revert back to a time when I had to be prepared for life or death situations. I feel like anything could and will happen. As old beliefs and thought patterns are stripped away I’m able to look at my experience from a more unbiased perspective. I can begin to see that I am no longer living a life that is fraught with danger.

I have so many conflicting feelings about these alters. I feel so very sorry that they had to experience the terrors of abuse and at the same time so grateful for all they’ve done to help me survive. And yet, I can’t seem to accept that I am also somehow them. That their triumphs and skills are my own. I can’t forgive myself for what they went through. I can’t take credit for what they’ve accomplished. There’s still much work to be done but the focus is shifting from needing validation from men, to recognizing and honoring my experience myself.